Testicular Germ Cell Tumors in Prepubertal Children

Kusumakumary, P; Mathew, Beela Sarah; Hariharan, S.; Priyakumari, T.; Rajan, BK

doi:10.1080/088800100276721

Cited by 8 publications

(2 citation statements)

References 16 publications

(28 reference statements)

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“…It is generally agreed upon that surveillance is the best option for stage I NSGCTT in childhood (2)(3)(4)(15)(16)(17), avoiding any unwarranted treatment in patients without metastatic disease, a primary objective in the management of children, especially since the salvage rate is very high and most relapsing patients will be cured by chemotherapy and surgery.…”

Section: Discussionmentioning

confidence: 99%

Clinical Stage I Nonseminomatous Germ Cell Tumors of the Testis in Childhood and Adolescence: An Analysis of 31 Cases

Terenziani

Piva

Spreafico

et al. 2002

Journal of Pediatric Hematology/Oncology

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A 20-year single-institution experience of clinical stage I nonseminomatous germ cell tumors of the testis (NSGCTT) in childhood and adolescents was reviewed in relation to clinical characteristics, treatment modalities, and survival. Thirty-one patients with clinical stage I NSGCTT were seen between 1980 and 2000: 14 children and 17 adolescents. Yolk sac tumors and/or teratomas occurred in the children, whereas mixed histologies, including embryonal carcinoma, were predominant in the adolescents. After orchiectomy, the children were assigned to surveillance and the adolescents to active treatment: 16 underwent retroperitoneal lymph node dissection (RPLND) and 1 had adjuvant cisplatin-based chemotherapy because of a high-risk histology. Three of the 14 children (21.4%) relapsed 3, 7, and 8 months after orchiectomy: all 3 had yolk sac tumors and presented with increased alpha-fetoprotein levels. No patients had retroperitoneal relapse; two recurred locally and one in the lung. All three children were treated with cisplatin-based chemotherapy with or without surgery. Among the 16 adolescents undergoing RPLND, 4 (25%) had nodal metastases. Three of the 12 patients (25%) who had negative nodes at RPLND relapsed in the lung 3, 7, and 8 months after RPLND. All were treated with cisplatin-based chemotherapy with or without surgery. Five-year relapse-free and overall survival rates for the whole series were 80.6% and 100%, respectively. This series enabled the authors to pinpoint several important aspects of stage I NSGCTT in children and adolescents. In particular, almost all the childhood cases had the same yolk sac tumor histology, the children tended to have localized disease, and an increased alpha-fetoprotein level had a very high predictive value, suggesting that follow-up should include AFP measurements. A conservative approach is the best option in children, while adolescent NSGCTT behaves like the adult disease and management must include similar treatment strategies.

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Section: Discussionmentioning

confidence: 99%

Clinical Stage I Nonseminomatous Germ Cell Tumors of the Testis in Childhood and Adolescence: An Analysis of 31 Cases

Terenziani

Piva

Spreafico

et al. 2002

Journal of Pediatric Hematology/Oncology

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“…In contrast to many teratomas in postpubertal patients, prepubertal testicular teratomas have behaved in an almost uniformly benign fashion, 1,4 even when immature elements are present. [60][61][62] (The one exception we are aware of was an 11-cm immature teratoma that developed in the intraabdominal testis of a 3-month-old infant and metastasized as immature teratoma to a retroperitoneal lymph node 3 months after orchiectomy. 63 He received chemotherapy and had no evidence of tumor 3 years later.…”

Section: Teratomamentioning

confidence: 99%